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of micturition but also lessens the actual momentary
discomfort. Severe headache is not uncommon in
appendicitis and is best relieved lisinopril 20mg by the use of the ice
bag. The feeding of the patient is of online lisinopril the greatest
importance. A feeding cup should be used in every
instance, as on no account must the patient be al-
lowed to move from the recumbent posture. The
author gives a teaspoonful of beef jelly every two
hours, with milk and barley water in addition. In
fact the less food given the better. A surgeon should
only be called in when, in spite of careful treatment,
the patient grows steadily worse. Many cases of
appendicitis are operated on which would have made
a good recovery under medical treatment. The au-
thor cites three cases of appendicitis, all of which
made satisfactory recoveries under medical treat-
ment. lisinopril 10mg From them and other cases he draws the fol-
lowing conclusions : (i) Although, when first seen, lisinopril hctz 12.5 mg
a case of appendicitis mav not seem very serious, the
patient may with 20 mg lisinopril remarkable rapidity develop ver^
grave symptoms. (2) The temperature is not nearly
so important as the pulse and is likely to vary to a
greater extent during the progress of the illness than
does the pulse-rate. (3) A pulse-rate of 120, though
necessarily giving rise to anxiety, need not indicate lisinopril 10 mg
operative intervention. (4) lisinopril 40 mg We are not entitled to
give up any case as hopeless, even though the patient
seems in immediate danger and operation is refused.
Some, at least, of such cases, do eventually recover.
SURGERY purchase lisinopril AND ANATOMY.
Obstruction of the Bowels from Meckel's lisinopril hctz 20 Di-
verticulum. — Dr. James E. Moore {Journal of the
American Medical Association, October 4th) savs
that the symptoms of obstruction from lisinopril buy a diverti-
culum are those of obstruction from any cause, but
occasionally they are of such a character as to make
an accurate hctz 12.5 lisinopril diagnosis possible. The suggestion
that the possession of a harelip, clubfoot, or other
congenital deformity, by a patient suffering from
obstruction of the bowels, would point to a diverti-
culum as the probable cause of the obstruction is
not, in the author's opinion, a practical one and might
even be misleading. Localized meteorism in the
right inguinal region in a young male patient is
strong presumptive evidence of obstruction from a
diverticulum. The treatment of intestinal obstruc-
tion from Meckel's diverticulum does not differ from
that of obstruction from any cause, for only rational
treatment in all cases is early operation, but a posi-
tive diagnosis would aid the surgeon in securing an
early operation and would help him to locate his in-
cision properly. Fitz concludes that in operation for
acute intestinal obstruction not due to intussusception
and without local symptoms the incision should be
made in the right lower quadrant. The main points
in the operation are to remove the obstruction as
early lisinopril 5 and as quickly as possible, and when the condi- lisinopril 12.5 mg
tion of the patient will lisinopril 10 permit, to remove the diverti-
culum. Under these conditions the prognosis is
remarkably good, but when operation is delayed it is
necessarily bad.
Experiences with the Roth-Drager Oxygen An-
aesthesia Apparatus. — Dr. Fritz Engelmann {Cen-
tralblatt fiir Chirurgie, September 13th) sums lisinopril 20 up
the advantages of the apparatus as follows : i. The
diminished danger, owing to the constant quantity of
exactly estimated chloroform administered, and the
impossibilitv of giving too much chloroform, as well
as the simultaneous administration of oxygen and
atmospheric air with the chloroform vapor; 2. the
solid construction of the apparatus and the simplicity
of the technics of its use. The anaesthetist has oni
hand free, which is not the case when the drop
method is used. The mask can be sterilized, and the
apparatus is so constructed that the depth and fre-
quency of the respirations can be easily detected.
Notes of Three Cases of Inoperable Cancer of
the Breast Treated by Removal of the Ovaries.
By D'Arcy Power, F. R. C. S. {Lancet, October
4th). — The author reports three cases of inoperable
cancer of the breast, in which the ovaries were re-
moved in the hope of benefiting the patients.
Case I. cheap lisinopril — A single woman, aged fifty-two years,
suffering from ascites and a large fungating cancer
of the right breast. The fungating breast was re-
moved (without the glands), together with both
ovaries. The patient made a good recovery and
lived for six lisinopril 5 mg months. The removal of the ovaries
had no effect on the cancer, but she was made more
comfortable by the removal of her ascites.
Case 2. — A widow, aged fortv-two years, suffer-
ing from a large cancer of the right breast with nu-
merous secondary growths. The ovaries were re-
moved ; one month later the patient had gained seven
pounds in weight and felt much better. The growth
in the breast and the axillary glands were decidedly
smaller. Two months later the condition of the pa-
tient was even better.
Case J.- — A very fat woman, aged fifty-five years,
suffering from cancer of the left breast. This was
inoperable on account of its size and extent. Both
ovaries were removed, but without the slightest ef-
fect upon the disease of the breast.
Results of Operations on the Kidney for Tuber-
culosis. — Dr. Edgar Garceau {Annals of Surgery,
October) records the statistics of two hundred and
ninety-three cases from which he draws the follow-
ing conclusions : ( i ) Tuberculosis is rarely, if ever,
primary in the kidney, and the original focus is in
some other organ in more direct contact with the
external air in the majofity of cases. (2) The pres-
ence of a primary focus of disease in the body, even
if the lisinopril 12.5 disease has been thoroughly eradicated from
the urinary tract, makes the ultimate prognosis in
these cases, doubtful at least. (3) Such foci may
remain permanently quiescent, but they may also be
PITH OF CURRENT order lisinopril LITERATURE.
[N. Y. Med. Joub.,